Ecological Momentary Assessment in Hearing Disorders

描述(申请人提供)：美国中年人中最常见的两种听力障碍是听力损失和耳鸣。在55岁或以上的人中，约有32%的人自我报告患有听力损失，目前约有8%的成年人报告说，他们每天或所有时间都会感到耳鸣或嗡嗡声。最近的数据表明，在美国，年龄调整后的听力损失和耳鸣的患病率可能正在上升。然而，只有相对较小比例的患有这两种疾病的成年人会寻求耳鸣或听力损失的治疗。事实上，目前只有大约25%的成人听力损失患者使用助听器，一些数据显示，只有大约37%的自称经常耳鸣的成年人向医疗保健专业人员报告了这种情况。使用标准问卷方法的研究表明，那些同时患有听力损失和耳鸣的人报告说，他们的问题和痛苦通常是间歇性的和情境性的。认知心理学数十年的研究表明，人们在回忆和报告健康问题和症状的方式上存在已知和可预测的偏差，特别是那些严重程度可能起伏不定或在特定情况下更频繁发生的偏差。为了对与健康问题相关的日常现实生活体验提供更敏感的衡量标准，多个领域的临床研究人员转向了一种名为生态瞬时评估(EMA)的技术。本质上，标准的个人数字助理(PDA)被编程为在预设的、随机的或参与者选择的时间点向患者/参与者发送声音或振动警报。此警报用于提示您使用PDA指示笔和触摸屏提供一系列评估。通过要求个人提供症状、痛苦和接近发生时间的情况的报告，回忆和报告的偏差可以大大减少，并且可以检查症状或痛苦的昼夜或其他形式的时间变化。该项目的目标是进行初步研究，研究EMA方法在听力损失和耳鸣方面的应用。在研究1中，我们将在24名研究参与者接受新的、技术更先进的助听器之前和之后的1周内，检查听力困难和痛苦的时间和情景评级。在研究2中，我们将对24名先前报告经历过严重耳鸣的研究参与者进行为期两周的情况和时间变化的耳鸣严重程度和痛苦程度评级的检查。在这两项研究中，使用EMA方法获得的数据将与标准的临床评估工具进行比较。这两项研究的发现和方法将指导未来使用EMA技术的临床研究。此外，随着便携式计算设备和助听设备基础技术的融合，这些试点研究可以作为未来在现实生活日常设置中整合听力测量和基于问卷的数据流的研究计划的基础。 公共卫生相关段落：虽然听力损失和耳鸣是中老年美国人最常见的两个听力问题，但大多数患有这些疾病的人并不寻求治疗。这项调查的目的是使用基于PDA的技术来研究听力损失和耳鸣对人们日常活动的影响。我们希望这一试点项目将为未来的临床研究提供基础，以检验听力障碍对日常生活的实时、真实世界影响。

DESCRIPTION (provided by applicant): The two most common auditory disorders among middle-aged Americans are hearing loss and tinnitus. Approximately 32% of those 55 years of age or older have self-reported hearing loss and about 8% of all adults currently report that they experience a ringing or buzzing in the ears daily or all of the time. Recent data indicate that the age-adjusted prevalence of both hearing loss and tinnitus may be increasing in the United States. However, only a relatively small proportion of adults with either condition will seek treatment for tinnitus or hearing loss. Indeed, only about 25% of those with adult-onset hearing loss currently use hearing aids and some data have shown that only about 37% of adults who say that they have constant ringing in the ears have reported this condition to a health care professional. Studies utilizing standard questionnaire methods have shown that those suffering from both hearing loss and tinnitus report that their problems and distress are often episodic and situational. Several decades of research in cognitive psychology have shown that there are known and predictable biases in the way people recollect and report health problems and symptoms, particularly those that may wax and wane in severity or occur more frequently in specific situations. In an effort to provide a more sensitive measure of the day-to-day real-life experiences associated with health problems, clinical researchers in a variety of fields have turned to a technique known as ecological momentary assessment or EMA. In essence, a standard Personal Digital Assistant (PDA) is programmed to signal a patient/participant with an audible or vibratory alert at either preset, random, or participant-chosen time points. This alert serves as a prompt to provide a series of assessments using a PDA stylus and touch screen. By asking individuals to provide reports of symptoms, distress, and situations close to the time of occurrence, recall and report biases may be substantially reduced and diurnal or other forms of temporal variation in symptoms or distress may be examined. It is the objective of the project to conduct pilot studies examining the applications of EMA methods to both hearing loss and tinnitus. In Study 1, we will examine temporal and situational ratings of hearing difficulty and distress for a 1-week period before and after 24 research participants have received a new and more technologically advanced hearing aid. In Study 2, we will examine situational and temporal variation in ratings of tinnitus severity and distress for a 2-week period in 24 research participants who have previously reported experiencing severe tinnitus. In both studies, data obtained with EMA methods will be compared to standard clinical assessment tools. The findings and methods developed in these two studies will guide future clinical research using EMA technologies. Further, as the technologies underlying portable computing devices and hearing assistive devices converge, these pilot studies may serve as the foundation for a future program of research integrating both audiometric and questionnaire-based data streams in real-life day-to-day settings. Public Health Relevance Paragraph: Although hearing loss and tinnitus are the two most common hearing problems among middle-aged and older Americans, most of those who experience these disorders do not seek treatment. The objective of this investigation is to use a PDA-based technology to study the effect of hearing loss and tinnitus on people as they go about their daily activities. It is our hope that this pilot project will provide the basis for future clinical research examining the real-time real-world impact of auditory disorders on everyday life.